(Raleigh, N.C.) – State Treasurer Dale. R. Folwell, CPA, applauds the Biden administration’s action to protect patients from surprise medical billing. The U.S. Department of Health and Human Services issued a rule Thursday, July 1, under the bipartisan No Surprises Act passed by Congress in 2020 to ban most surprise billing practices.
Surprise billing happens when patients unknowingly get care — and the accompanying higher charges — from a provider not in their insurance company’s network. That can happen even at in-network facilities.
The consequences can be devasting for patients’ financial health. Two-thirds of U.S. bankruptcies are linked to medical expenses. Almost 72% of Americans say that medical debt has prevented them from achieving life’s milestones, including having children or buying a home.
Treasurer Folwell supports the move to guard the financial health of patients and push the power back to the consumer.
“A majority of Americans think they’re one medical bill away from losing their upward mobility. Surprise billing has an especially disproportionate impact on lower- and fixed-income public servants,” said Treasurer Folwell. “We are pleased that Congress and the administration have taken action to protect patients. This is a critical step in the right direction. We hope that they will continue acting to protect patients’ rights to know the price of their care.”
After the rule takes effect on Jan. 1, 2022, emergency services must be treated on an in-network basis. This means that patients will no longer face paying inflated prices if they are rushed to an out-of-network hospital during an emergency. Patients will no longer receive surprise out-of-network charges at in-network facilities. This means that patients can rest easy, knowing they won’t be surprised by a bill from an out-of-network anesthesiologist or assistant surgeon.
Americans will also gain the ability to protect their own financial health. Providers must notify patients, in plain English, when they could face higher bills for out-of-network care.
The new rules have the potential to lower insurance premiums and save taxpayers $17 billion in federal deficit reduction over 10 years. Consumers could save about twice that number between reduced cost-sharing and premiums, according to estimates by the Congressional Budget Office. The savings will depend on the arbitration process that out-of-network providers and insurers will use to negotiate payments.
“As former Gov. Jim Martin always says, ‘Doing right is rarely wrong.’ It shouldn’t take a law for providers to do what’s right,” said Treasurer Folwell. “Patients deserve to know the price before they get the bill. Providers should stop putting profits over their patients and comply with federal rules.”
The State Health Plan (SHP), a division of the N.C. Department of State Treasurer, provides health care coverage to almost 750,000 teachers, current and former lawmakers, state university and community college personnel, active and retired state employees, and their dependents.
For more information on the SHP please visit SHPNC.org.